Stewart Jesse W, Ringqvist Jenny, Wooldridge Rachel D, Farr Deborah E, Sunna Mary, Schulz Cedar, Alexander John C, Minhajuddin Abu, Gasanova Irina, Joshi Girish P
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Proc (Bayl Univ Med Cent). 2021 May 10;34(5):571-574. doi: 10.1080/08998280.2021.1919003. eCollection 2021 Sep.
This prospectively designed, clinical quality improvement project compared pain scores and opioid consumption between ultrasound-guided, erector spinae plane blocks (ESPB) and thoracic paravertebral blocks (PVB) in patients undergoing total bilateral mastectomies without reconstruction. Twenty-five patients were included in an enhanced recovery pathway and received an ESPB on one side and a PVB on the contralateral side. Numeric rating scores at rest and with movement for each side were recorded in the recovery room at 2, 6, 12, 24, and 48 hours and on days 3 to 7. There were no significant differences in the resting or movement-evoked pain scores between sides receiving ESPB or PVB at any time point up to day 7 after surgery. Both ESPB and PVB confer equal analgesic effects in patients undergoing mastectomies. ESPB provides an alternative to PVB in reducing postoperative pain in patients undergoing mastectomy as part of an enhanced recovery pathway.
这个前瞻性设计的临床质量改进项目，比较了在接受双侧全乳切除术且未进行乳房重建的患者中，超声引导下竖脊肌平面阻滞（ESPB）和胸椎旁神经阻滞（PVB）之间的疼痛评分和阿片类药物消耗量。25名患者纳入了加速康复路径，一侧接受ESPB，对侧接受PVB。在恢复室分别于术后2、6、12、24和48小时以及第3至7天记录每侧静息和活动时的数字评分。在术后第7天之前的任何时间点，接受ESPB或PVB的两侧之间，静息或活动诱发的疼痛评分均无显著差异。ESPB和PVB在接受乳房切除术的患者中具有同等的镇痛效果。作为加速康复路径的一部分，ESPB在减轻乳房切除术后患者的疼痛方面可替代PVB。
